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Renovascular Hypertension: Atherosclerotic Disease
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- Renovascular hypertension is defined as hypertension resulting from a lesion in the renal artery that is relieved by correction of the lesion or removal of the kidney
- Represents 2-5% of hypertensive cases, but is important because it is curable.
- Two major causes: atherosclerosis and fibromuscular dysplasias.
- Atherosclerosis is the most common cause (60-70%) of renovascular hypertension
- Clinical: involves proximal 2 centimeters; increased incidence in elderly and diabetics
- Gross: atheromatous plaque at the origin of the renal artery; may show recent thrombosis
- Microscopic features:
- proliferation of smooth muscle (myointimal) cells in the intima
- eventual lipid deposition, necrosis, and inflammation result in narrowing of the arterial lumen
- Treatment/ Prognosis: surgical removal results in cure rate of 60-75% of patients.
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